scholarly journals ‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

2020 ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen

Abstract BackgroundPublic home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services.MethodThis qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible.ConclusionThe results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.


2021 ◽  
pp. 108482232199477
Author(s):  
Tracy Chippendale ◽  
Patricia Gentile

Most people prefer to age in place. However, there is a growing body of literature to suggest a reluctance to accept supportive services in the home due to concerns about trust, privacy, cost, and fear of being a burden. The purpose of this study was to examine potential facilitators and barriers to accepting home care services in the website content of Licensed Home Care Service Agencies (LHSCA). In this linguistic analysis study, the written content from 88 randomly selected LHCSA websites was examined. We used LIWC2015 and Microsoft® Word software to analyze websites for relevant word categories that reflect older adult identified facilitators and barriers to the acceptance of home care services. Results revealed that the summary score for clout (i.e., confidence and leadership reflected in the writing) was high. Some of the most commonly used word categories were positive emotions, present focused, and affiliation. The word category money was included, but to a lesser degree. However, Burden and related words were highly prevalent in the writing sample. In summary, LHCSA website content contains both facilitators and barriers to the acceptance of home care services. Given the importance of home care services in promoting the ability of older adults to age in place, greater attention may be needed regarding the way services are presented and advertised to consumers.


2019 ◽  
Vol 5 ◽  
pp. 237796081984436
Author(s):  
Rita Sørly ◽  
Martin Sollund Krane ◽  
Geir Bye ◽  
May-Britt Ellingsen

Background: There is a need for qualitative studies on imposed innovation in home care services in welfare societies. The municipalities are key actors in the field of innovation in the public sector. As innovations often are interpreted to be in conflict with values in health care, we need knowledge on how policy changes and imposed innovations are understood and handled by middle managers working in the sector. Aim: We aim to explore how middle managers react to imposed innovation in health services through their storytelling. The research question was “What can middle managers' stories of imposed innovation tell us about their role in, and some important prerequisites for, innovation processes in municipal health-care services?” Methods: A narrative study of experiences with municipal innovation among middle managers in Norway. In this article, we do a thematic analysis of interviews with seven female middle managers who work in a home care service department. Findings: The study develops an understanding of which frameworks are required within a home care service to meet constant demands for innovation. Innovations are understood by the managers as results of policy changes and new public management demands and as a troublesome burden. We find the prerequisites for implementing innovations to be (1) trust-based management, (2) flexibility and dynamics, (3) continuity of care, and (4) emphasis on competence. These prerequisites are further interpreted in relation to dominant discourses on innovation at the macro, meso, and micro levels within the storytelling contexts. Conclusion: Imposed innovations require a negotiating practice in cross-disciplinary environments at all levels in the organization.


Author(s):  
Tzu-Pei Yeh ◽  
Hsing-Chia Chen ◽  
Wei-Fen Ma

Few studies have focused on developing a better understanding of the needs of patients with moderate-stage dementia. This study aimed to explore the needs of people living with moderate dementia and receiving home-care services from a local mental hospital. The study adopted a descriptive qualitative approach with purposive sampling to recruit patients with moderate dementia and receiving home-care services. Data were collected by face-to-face interviews and content analysis was used to interpret the experiences in the dialogue data. The results showed that the needs of people living with moderate dementia receiving home-care services contained four themes: the demand for company and care, the wish to recall familiar images, the need of reaffirming life purpose and value through reflection and reminiscence, and the desire for making autonomous end-of-life decisions. In addition to daily care, people living with moderate dementia crave companionship, expect meaningful exchanges of experiences to share their life, and have demands to have a voice in going through the final stage of life. The participants tended to focus more on issues related to the connections between living and dying. The results provide caregivers and home-care service providers with some insights into offering better care for people living with moderate dementia.


2020 ◽  
Vol 2 (1) ◽  
pp. 61-78
Author(s):  
Luciana Lolich ◽  
Virpi Timonen

This article examines the emotions of fear and feeling fortunate experienced by key actors in home-care services in Ireland. We take a relational approach to emotions; that is to say, an understanding that emotions are produced in social interactions and play an essential part in how people engage with, and respond to, long-term care policies. The study involved focus groups and in-depth interviews with 104 participants. Our findings show that the most vulnerable participants – service users and care workers on precarious contracts – feel fortunate or fearful about outcomes that had, or would have, a direct impact on them: respectively, having a good carer and obtaining job satisfaction, or losing a home-care package and not having enough work. Professionals were more likely to speak about luck and fear, not in relation to what could happen to them directly but in relation to the fate of service users and care workers. The unregulated home-care services in Ireland have influenced actors to construe their own and others’ participation in the system as increasingly individualised, where desired outcomes depend on one’s good luck or strong personal relationships. For the system to work properly trust needs to be present not only at the micro level of individual relationships but also at a system level. This could lead to a decline in emotions that centre on feeling fortunate and fearful, and an increase in expressions of trust and a sense of control by both care providers and care recipients.


2020 ◽  
Author(s):  
Letícia Lousada ◽  
Francisco Clécio Dutra ◽  
Beatriz Silva ◽  
Natália Oliveira ◽  
Ismael Bastos ◽  
...  

Abstract Background: Safety culture in primary care and home care services is still poorly studied, although this levels of care are the gateways to health services. This study aims to evaluate the culture of patient safety in Primary and Home Care Services. Methods: This is an observational cross-sectional study carried out with 147 professionals from nine district linked to the Home Care Program and six primary health care units. For the evaluation of culture, the Safety Attitudes Questionnaire (SAQ) was used, which considers a positive patient safety culture with scores ≥ 75. Results: Men who work in home care with time of professional experience of three to four years scored better for the Safety Climate, Job Satisfaction, Teamwork Climate and Total SAQ. Perception of management and Working Conditions received lower scores from professionals with long time of experience.Conclusions: It is concluded that the safety culture evaluation was better in the home care service when compared to the primary health care service.


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